A behavioural neuroscientist in Saskatoon is uncovering marijuana’s effects on fetal brain development.

After recently winning a five-year CIHR grant of $960,076 in the spring of 2024, Dr. John Howland’s lab at the University of Saskatchewan is expanding its work examining prenatal exposure to cannabis smoke. Howland’s teams will assess the way cannabis exposure alters higher brain functions like memory and learning in both rats and mice.

Compared to cannabis injections in the past, the professor of Anatomy, Physiology and Pharmacology at the College of Medicine said exposing rodents to high-potency smoke for up to 15 minutes at a time provides a more realistic picture of marijuana's effects on fetal brain development.

Over their lives, Howland will measure changes in cortical limbic circuitruity, for both rodent mothers and their offspring.

“The cortex is definitely involved, but we also look at other areas like the hippocampus and the amygdala,” said Howland. “There’s pretty good evidence that they are at least subtly affected after gestational exposure to cannabis.”

Now, it’s a matter of quantifying which circuits cannabis affects in the rodent brain — under circumstances as close to real-life human exposure as Howland's laboratory can create.

"It's not simple," said Howland. He notes a wide variety of phenotypes of THC and CBD strains are now available at retailers, each with its own characteristics and potential interactions with neurons.

“These receptors are involved in many discrete events during brain development,” he said. "We're hoping to be more controlled and more specific."

"It turns out a lot of things that are legal like alcohol and tobacco aren't that safe during pregnancy either," said Howland.

"I think more knowledge has to be helpful as women make these decisions for themselves.”

Growing up in Columbia had a profound impact on Dr. Juan-Nicolas Pẽna-Sànchez. In this episode, hear why the former family physician pivoted, becoming Saskatchewan's lead in finding the best ways to treat Crohn's disease and ulcerative colitis in rural and Indigenous patients.

Even as a teenager, Juan-Nicolás Peña-Sánchez could see stark differences in health for those who had medical coverage — and those without, thanks to his stepfather, an emergency department physician.

“I used to go with him sometimes on shifts to learn and shadow him,” said Peña-Sánchez said. “The healthcare system was quite fragmented and most of the population was not covered.”

In the 1990s, the Colombian healthcare system was reformed within the context of “neoliberal health reforms” promoted by the World Bank and International Monetary Fund, integrating privatization of the care delivery system, individual health insurance as the mechanism for receiving healthcare, the development of basic benefit plans, among other reforms.

“It changed the way to practice medicine,” said Peña-Sánchez, who observed among his stepfather and his medical school instructors’ grew dissatisfied with limits imposed under the new tiered coverage system.

Peña-Sánchez went on to work for non-governmental organizations in Bogotá, providing healthcare to individuals living in marginalized communities and with limited resources. After witnessing the inequities amplified by healthcare reforms, Peña-Sánchez began to analyze health systems themselves. He moved to Spain, Poland, and France to continue his graduate studies, and then to the University of Saskatchewan, where he joined the Department of Community Health and Epidemiology as an associate professor after researching physician satisfaction and alternatives to ‘fee-for-service’ payment models.

Still, Peña-Sánchez missed interacting directly with patients, and hearing their stories. Through the College of Medicine, he began learning about inflammatory bowel disease (IBD) and moved his focus to innovative models of care for IBD.

Canada’s high prevalence of IBD, particularly Crohn’s disease and ulcerative colitis, stood in stark contrast to his experiences in Colombia.

Dr. Peña-Sánchez formed the IBD among Indigenous Peoples Research Team after realizing in 2017 there was virtually no data on the incidence, prevalence or treatment of IBD for First Nations and Metis people.

“We learned that IBD is increasing among First Nations in Saskatchewan,” said Peña-Sánchez, who started zeroing in on disparities in those patients’ healthcare access and outcomes. Peña-Sánchez and his team explain their findings in this episode.

“Having that regular access is critical,” he said, advocating for innovative approaches to healthcare delivery.

Dr. Peña-Sánchez also explored the potential of virtual care, particularly telephone consultations, to improve healthcare access for rural populations. He found rural residents were more satisfied with telephone care compared to urban dwellers, an insight that underscores the need for adaptable healthcare models.

Currently, Dr. Peña-Sánchez is focused on patient navigation interventions to support individuals with chronic gastrointestinal conditions, particularly in rural Saskatchewan and for Indigenous community members. His research aims to improve access to specialized IBD care and patient outcomes through peer support and patient navigators.

"When I got into medical school, the last thing in the world I wanted to be was a surgeon because I couldn't stand the sight of blood," said Dr. Mike Moser.

Fast-forward to the present day, where Moser is now one of Saskatchewan's top kidney transplant surgeons, winning last year's Golden Scalpel Award for Pre-clerkship Education, the 2022 Logan Boulet Humanitarian of the Year Award, and numerous teaching awards.

In this episode, the professor of general surgery at the University of Saskatchewan's College of Medicine takes us back to one pivotal day where everything changed, propelling forward his career in Hepato-pancreato-biliary (HPB) surgery and organ transplants

Moser’s research has pushed forward transplant science, and led to safer kidney biopsies. Along with interventional radiologist Dr. Chris Wall, Moser led the charge to bring NanoKnife technology to Saskatchewan. His team has now spent a decade using the tool to treat otherwise inoperable tumors.

The NanoKnife relies on irreversible electroporation (IRE) — using electrical pulses to create tiny holes in tumor cells, causing them to die without harming surrounding structures.

"I love making those little, elegant, tiny connections," said Moser, whose work focuses on destroying cancer cells, while preserving delicate tissue.

Those two interests led to collaborations with various departments, including biomedical engineering, as well as chemistry, immunology, and pharmacology.

Moser is most excited today to see IRE combined with immunotherapy, to enhance the body's immune response against cancer.

"It's like a killed cell vaccine situation because we've got these dead, helpless cancer cells. They're still exposing their proteins," said Moser.

Although the research is still in its early stages, Moser said the results so far show "great potential" in treating metastatic cancers.

"One could actually treat the area where the tumor started without directly treating it,” he said.

"Pushing politicians to do what is good for the health of the people, there's no way around it," said Dr Jacob Alhassan.

Born and raised in a rural Ghanaian village, Alhassan grew up without electricty and paved roads. He watched women die in childbirth. He grew resentful of health systems that left the poorest people to fend for themselves, while the rich thrived.

Alhassan decided to take action.

At first, he thought he would study hard to become a local hospital administrator. Partway through his university years, Alhassan began to dream even bigger.

In this episode, he looks back at his arrival in Saskatoon, and how his trajectory to becoming an assistant professor of Community Health and Epidemiology was forever changed by provincial austerity measures that wiped out the Saskatchewan Transportation Company (STC).

Billed as a cut that would save taxpayers $85 million dollars over five years, Alhassan studied Hansard and the full debate around the public transit network's closure. He found little evidence supporting the decision to cut it.

"We have a political system that is not necessarily arranged for the well-being of average people," said Alhassan, who still remembers travelling to towns and cities across Saskatchewan to interview people devastated by the closure of the intercity bus service.

He said the cuts "radically changed" some people's lives, in some cases shortening them. Losing the parcel service also cost the provincial health care system more, with patients delaying medical care, and pharmacists throwing out delayed and weather-damaged medication and vaccines.

"It's literally a might-makes-right sort of thing, where the most powerful people make decisions that deeply impact the lives of people who don't really have the voice to raise their concerns or to be heard," Alhassan said.

Today, Alhassan's looking more closely at health outcomes tied to public transportation, and their financial impact on taxpayers. He's also one of the academic co-leads of the University of Saskatchewan's Certificate in Global Health.

"You cannot do this type of work to improve people's health if you disconnect yourself from the politics," said Alhassan. "That's not going to happen if I kind of sit in the ivory tower and kind of disconnect myself from the political aspect of this. I strongly believe in that."

Dr. Sabira Valiani was one of the frontline physicians working inside Saskatoon’s critical care units four years ago, during the initial lockdowns of the Covid-19 pandemic.

“It was really weird,” said Valiani.

Valiani said ‘a lot of light bulbs went off in my head’ amid the automated stillness of the unit, as she watched ventilators breathing for heavily sedated patients.

Covered in head-to-toe personal protective equipment, staff in the intensive care unit struggled to simultaneously treat patients, communicate with family members, and enforce hospital policies.

“Those patients aren’t talking to us,” Valiani said. “It was empty, it was overwhelming and it was disconnected all at the same time.”

Valiani has now spent seven years in critical care, a move that started with her enrolling in a critical care and ICU elective in Ottawa.

“I loved it. I loved on the medical side, how you could see the life support that you were giving a patient immediately have a physiologic effect and stabilize that patient,” she said.

Driven by her experiences during the pandemic, Dr. Valiani delved into research focused on improving patient and family experiences in the ICU. She collaborated with a multidisciplinary team and patient partners to understand the challenges faced by healthcare providers and families alike.

In this article for the Canadian Association of Critical Care Nurses, she and her colleagues examined the effect of visitor restrictions during the pandemic.

Valiani remembers tearful goodbyes, families gathered around screens, unable to hug or touch loved ones infected and dying with Covid-19.

"The family's role becomes significantly diminished,” she said. “So much of that was disrupted during that time."

In the months and years that followed, visitor restrictions relaxed, but Valiani noticed communication between families, patients and staff still felt awkward.

Valiani and her colleagues turned their lens last year to key moments for Canadians of diverse ethnicities during the critical care journey, in the Canadian Journal of Anesthesia. The findings revealed the strain on healthcare providers playing multiple roles and families feeling disconnected from crucial information.

She estimates 30 per cent of Saskatoon’s ICU patients travel from remote communities, making it crucial to find ways to keep family members informed in a language they understand well.

“People kind of naturally turned towards communication technology in the pandemic,” said Valiani, noting a number of families cannot be present in-person during the day, as intensivists attend rounds.

Clear and open communication between patients, care providers and families is the key, Valiani said.

“What if we could use artificial intelligence or AI to just translate a medical progress note into an understandable family update?” Valiani asked.

“It doesn't have to be high tech, right? Like it can be a phone call.”

Together with the Saskatchewan Health Research Foundation, Dr. Valiani now works at enhancing patient-family engagement through practical solutions. She emphasizes the importance of involving families in care decisions, acknowledging their unique expertise in understanding patients' wishes.

Her team presented its findings in 2022 at Toronto’s Critical Care Canada Forum.

“We have this cohesive approach to defining the problems,” said Valiani. “Now we can take this to decision makers and say….these are the things people living this experience actually want.”

Daphne Yau can trace her interest in endocrinology back to a beta-cell physiology experiment during her master’s degree,  working with laboratory mice with Type 2 Diabetes.

“It was the part of the pancreas that makes insulin,” she said. “It was fascinating. It also made me realize that maybe pure laboratory research wasn't quite for me."

From there, her interest in hormones and fluctuating blood sugar levels grew.

Yau is no stranger to medicine. Her mother was a pharmacist, while her father and aunt both worked as physicians. Following in their footsteps, Lou completed her pediatrics residency at Queen’s University, with fellowship training at McGill. She then focused on congenital hyperinsulinism at the Children’s Hospital of Philadelphia and Royal Manchester Children’s Hospital.

She still remembers her residency, and meeting a premature baby with a rare genetic disorder  in neonatal intensive care.

“The blood sugars were horrendously low right from the start,” Yau said. “Their brain uses most of that glucose, so that's why it's so critical in that period that they get a steady supply.”

Together with an endocrinologist and a multi-disciplinary team, Yau and her colleagues traced back the root of the hyperinsulinism — the infant’s mother and grandmother also suffered from rare forms of diabetes.

Unregulated, plummeting blood sugar levels in infants can cause brain injuries and permanent neurological damage, Yau said.

“Your brain can't really store much in the way of glucose and it can't make it on its own the way some other tissues and organs in the body can,” said Yau.

“If you test a child who's had hypoglycemia when they're two or four, you may not actually pick up on this. Not till maybe later on, when they're in school and they're struggling.”

Yau joined the College of Medicine five years ago as a pediatric endocrinologist and assistant professor of pediatrics. Today, she’s based at the Jim Pattison Children’s Hospital. Her research focuses on understanding and addressing congenital hyperinsulinism, as well as screening for diabetes and other metabolic disorders.

In this episode, Dr. Yau pointed to recent success with a project inspired by Dr. Mark Inman. Together, their team is trying to improve diabetes screening and education in northern Saskatchewan, particularly for Indigenous children and teenagers.

She said the heel prick hospitals often perform on newborns inspired them.

“Could someone at home prick their finger, put some few drops of blood on this card and have their A1C measured that way as opposed to having to go to the lab?” Yau said.

The results to date show promise, which could make it easier to screen young patients in remote communities for diabetes.

Yau is also working with researchers in the United Kingdom who study blood sugar dysregulation in infants, exploring alternative treatments and lower doses of medications such as diazoxide, to mitigate side effects.

“What are the levels we really should be targeting to minimize the potential for long-term harms?”